ATI Pharm Practice B

A nurse in the emergency department is caring for a client who took 3 nitroglycerin tablets sublingually for chest pain. The client reports relief from the chest pain but now he is experiencing a headache. Which of the following statements should the nurse make? 1)"A headache is an indication of an allergy to the medication." 2)"A headache is an expected adverse effect of the medication." 3)"A headache indicates tolerance to the medication." 4)"A headache is likely due to the anxiety about the chest pain."

"A headache is an expected adverse effect of the medication."

A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give? 1)"It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level." 2)"A pharmacist is the person to answer that question." 3)"Heparin does not dissolve clots. It stops new clots from forming." 4)"The oral medication you will take after this IV will dissolve the clot."

"Heparin does not dissolve clots. It stops new clots from forming."

A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication? 1)"I can walk a mile a day." 2)"I've had a backache for several days." 3)"I am urinating more frequently." 4)"I feel nauseated and have no appetite."

"I feel nauseated and have no appetite."

A client is teaching a client who has a new prescription for hydrochlorothiazide for management of hypertension. Which of the following instructions should the nurse include? 1)"Take this medication before bedtime." 2)"Monitor for leg cramps." 3)"Avoid grapefruit juice.'" 4)"Reduce intake of potassium-rich foods."

"Monitor for leg cramps."

A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make? 1)"Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level." 2)"I will call the provider to get a prescription for discontinuing the IV heparin today." 3)"Both heparin and warfarin work together to dissolve the clots." 4)"The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay."

"Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level."

A nurse is teaching a client who has a new prescription for clopidogrel. Which of the following instructions should the nurse include? 1)"Take this medication with food." 2)"You might have to stop taking this medication 5 days before any planned surgeries." 3)"Take this medication three times daily." 4)"Expect to have black-colored stools while taking this medication."

"You might have to stop taking this medication 5 days before any planned surgeries."

A nurse is caring for a client who has a prescription for 3,000 mL of dextrose 5% in 0.45% sodium chloride to infuse IV over 24 hr. The nurse initiates an IV infusion of 1,000 mL of this fluid at 0800. At what time should the nurse prepare to initiate the second 1,000 mL bag? 1)1600 2)2400 3)1200 4)1800

1600

A nurse is caring for a client is who has a deep vein thrombosis and is prescribed heparin by continuous IV infusion at 1,200 units/hr. Available is heparin 25,000 units in 500 mL D5W. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest tenth/whole number. Use a leading zero if it applies. Do not use a trailing zero.)

24

A nurse is caring for a client who received an injection of penicillin G procaine. The client begins to experience dyspnea and tongue swelling. Which of the following actions should the nurse perform first? 1)Obtain intravenous fluids for administration. 2)Record the observed data in medical record. 3)Deliver a dose of aminophylline by inhalation. 4)Administer epinephrine subcutaneously.

Administer epinephrine subcutaneously.

A nurse is caring for a client who has developed gout. Which of the following medications should the nurse prepare to administer? 1)Zolpidem 2)Alprazolam 3)Spironolactone 4)Allopurinol

Allopurinol

A nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. The client states, "I don't need this medication. I am not constipated." The nurse should explain that in clients who have cirrhosis, lactulose is used to decrease levels of which of the following components in the bloodstream? 1)Glucose 2)Ammonia 3)Potassium 4)Bicarbonate

Ammonia

A nurse is providing teaching to a client who has emphysema and a new prescription for theophylline. Which of the following instructions should the nurse provide? 1)Consume a high-protein diet. 2)Administer the medication with food. 3)Avoid caffeine while taking this medication. 4)Increase fluids to 1L/per day.

Avoid caffeine while taking this medication.

A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first? 1)Check the client's vital signs. 2)Request a dietitian consult. 3)Suggest that the client rests before eating the meal. 4)Request an order for an antiemetic.

Check the client's vital signs

A nurse is caring for four clients. After administering morning medications, she realizes that the nifedipine prescribed for one client was inadvertently administered to another client. Which of the following actions should the nurse take first? 1)Notify the client's provider. 2)Check the client's vital signs. 3)Fill out an occurrence form. 4)Administer the medication to the correct client.

Check the client's vital signs

A nurse is assessing a client who is receiving a unit of packed red blood cells. Which of the following findings is a manifestation of acute hemolytic reaction? 1)Client report of low back pain 2)Client report of tinnitus 3)A productive cough 4)Distended neck veins

Client report of low back pain

A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. Which of the following findings indicates a therapeutic response to the medication? 1)Decrease in level of thyroxine (T4) 2)Increase in weight 3)Increase in hr of sleep per night 4)Decrease in level of thyroid stimulating hormone (TSH).

Decrease in level of thyroid stimulating hormone (TSH).

A nurse is caring for a client who has diabetes insipidus and is receiving vasopressin. The nurse should identify which of the following findings as an indication that the medication is effective? 1)A decrease in blood sugar 2)A decrease in blood pressure 3)A decrease in urine output 4)A decrease in specific gravity

Decrease in urine output The major manifestations of diabetes insipidus are excessive urination and extreme thirst. Vasopressin is used to control frequent urination, increased thirst, and loss of water associated with diabetes insipidus. A decreased urine output is the desired response.

A nurse is teaching a client how to draw up regular insulin and NPH insulin into the same syringe. Which of the following instructions should the nurse include? 1)Draw up the NPH insulin into the syringe first. 2)Inject air into the regular insulin first. 3)Shake the NPH insulin until it is well mixed. 4)Discard regular insulin that appears cloudy.

Discard regular insulin that appears cloudy.

A nurse is providing discharge teaching for a client who has pulmonary edema and is about to start taking furosemide. Which of the following instructions should the nurse include? 1)Take aspirin if headaches develop. 2)Eat foods that contain plenty of potassium. 3)Expect some swelling in the hands and feet. 4)Take the medication at bedtime.

Eat foods that contain plenty of potassium.

A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if her blood glucose level is above 200 mg/dL. Which of the following information should the nurse include? 1)Discard the NPH solution if it appears cloudy. 2)Shake the insulin vigorously before loading the syringe. 3)Expect the NPH insulin to peak in 6 to 14 hr. 4)Freeze unopened insulin vials.

Expect the NPH insulin to peak in 6 to 14 hr.

A nurse on a medical unit is planning care for an older adult client who takes several medications. Which of the following prescribed medications places the client at risk for orthostatic hypotension? (Select all that apply.) 1)Furosemide 2)Telmisartan 3)Duloxetine 4)Clopidogrel 5)Atorvastatin

Furosemide, telmisartan, duloxetine

A nurse is assessing a client prior to administering atenolol. Which of the following findings should prompt the nurse to withhold the medication? 1)Heart rate 46/min 2)Oxygen saturation 95% 3)Respiratory rate 18/min 4)Blood pressure 160/94 mm Hg

Heart rate 46/min

A nurse is preparing to administer verapamil by IV bolus to a client who is having cardiac dysrhythmias. For which of the following adverse effects should the nurse monitor when giving this medication? 1)Hyperthermia 2)Hypotension 3)Ototoxicity 4)Muscle pain

Hypotension

A nurse is monitoring a client who is receiving a unit of packed RBCs following surgery. Which of the following assessments is an indication the client might be experiencing a hemolytic reaction? 1)Flushing 2)Dyspnea 3)Hypotension 4)Vomiting

Hypotension A hemolytic reaction causes hypotension, headache, apprehension, chest pain, and low-back pain.

A nurse is teaching a client who has chronic kidney disease and a new prescription for epoetin alfa. The nurse should instruct the client to increase dietary intake of which of the following substances? 1)Iron 2)Protein 3)Potassium 4)Sodium

Iron

A nurse in a provider's clinic is caring for a client who reports erectile dysfunction and requests a prescription for sildenafil. Which of the following medications currently prescribed for the client is a contraindication to taking sildenafil? 1)Isosorbide 2)Phenytoin 3)Metronidazole 4)Prednisone

Isosorbide

A nurse is caring for a client who has tuberculosis and new prescriptions for rifampin and pyrazinamide. Which of the following laboratory tests should the nurse instruct the client will be required while on this medication regimen? 1)Liver function tests 2)Gallbladder studies 3)Thyroid function studies 4)Blood glucose levels

Liver function tests

A nurse is assessing a client who has hypercholesterolemia and is receiving simvastatin. Which of the following findings should the nurse recognize as a potential adverse effect? 1)Urinary retention 2)Muscle weakness 3)Orthostatic hypotension 4)Blurred vision

Muscle weakness

A nurse is reviewing the laboratory data on a client who has a new prescription for heparin for treatment of a pulmonary embolism. Which of the following data should the nurse report to the provider? 1)Hematocrit 45% 2)Partial thromboplastin time (PTT) 65 seconds 3)White blood cell count 8,000/mm3 4)Platelets 74,000/mm3

Platelets 74,000/mm3

A nurse is caring for a client who has heart failure and a new prescription for furosemide. Which of the following laboratory values should the nurse review before administering furosemide? 1)Bicarbonate 2)Carbon dioxide 3)Potassium 4)Phosphate

Potassium

A nurse is reviewing the medication list for a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize which of the following medications can cause glucose intolerance? 1)Cimetidine 2)Dextromethorphan 3)Prednisone 4)Atorvastatin

Prednisone

A nurse is caring for a client who asks how albuterol helps his breathing. Which of the following responses should the nurse make? (Select all that apply.) 1)The medication will stimulate flow of mucus. 2)The medication will prevent wheezing. 3)The medication will open the airways. 4)The medication will reduce inflammation. 5)The medication will decrease coughing episodes.

Prevent wheezing, open airways, and decrease coughing episodes

A nurse in a coronary care unit is admitting a client who has had CPR following a cardiac arrest. The client is receiving lidocaine IV at 2 mg/min. When the client asks the nurse why he is receiving that medication, the nurse should explain that it has which of the following actions? 1)Prevents dysrhythmias 2)Slows intestinal motility 3)Dissolves blood clots 4)Relieves pain

Prevents dysrhythmias

A nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia? 1)Furosemide 2)Hydrochlorothiazide 3)Metolazone 4)Spironolactone

Spironolactone

A nurse is assessing a client who is receiving dopamine IV to treat left ventricular failure. Which of the following findings should indicate to the nurse that the medication is having a therapeutic effect? 1)Systolic blood pressure is increased 2)Cardiac output is reduced 3)Apical heart rate is increased 4)Urine output is reduced

Systolic blood pressure is increased

A nurse is caring for a client who is taking montelukast. Which of the following outcomes indicates a therapeutic effect of the medication? 1)The client experiences less muscle pain. 2)The client's seizure threshold is reduced. 3)The client experiences an increased ease of breathing. 4)The client's platelet count is increased.

The client experiences an increased ease of breathing.

A nurse is reviewing the health history for a client who has angina pectoris and a prescription for propranolol hydrochloride PO 40 mg twice daily. Which of the following findings in the history should the nurse report to the provider? 1)The client has a history of hypothyroidism. 2)The client has a history of bronchial asthma. 3)The client has a history of hypertension. 4)The client has a history of migraine headaches.

The client has a history of bronchial asthma.

A nurse is completing a medical interview with a client who has elevated cholesterol levels and takes warfarin. The nurse should recognize that which of the following actions by the client can potentiate the effects of warfarin? 1)The client follows a low-fat diet to reduce cholesterol. 2)The client drinks a glass of grapefruit juice every day. 3)The client sprinkles flax seeds on food 1 hr before taking the anticoagulant. 4)The client uses garlic to lower cholesterol levels.

The client uses garlic to lower cholesterol levels.

A nurse is reviewing the medication list for a client who has a new prescription for warfarin. The nurse should recognize that which of the following medications is incompatible with warfarin? 1)Furosemide 2)Alprazolam 3)Vitamin K 4)Vitamin A

Vitamin K

A nurse is collecting data on a client who has a new prescription for ampicillin. The nurse should recognize which of the following findings is a priority? 1)Nausea 2)Vomiting 3)Wheezing 4)Moniliasis

Wheezing